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The Public Health Dimension of Disasters—Health Outcome Assessment of Disasters

Published online by Cambridge University Press:  28 June 2012

Bellis van den Berg
National Institute for Public Health and the Environment (RIVM), Environmental Health Research, Bilthoven, the Netherlands
Linda Grievink*
National Institute for Public Health and the Environment (RIVM), Environmental Health Research, Bilthoven, the Netherlands
Kersten Gutschmidt
World Health Organization (WHO), Geneva, Switzerland
Thierry Lang
Institut National de la Santé et de la Recherche Medicale (INSERM), U558 Toulouse, France
Stephen Palmer
Health Protection Agency (HPA), Local and Regional Services, Cardiff University, UK
Marc Ruijten
Crisis Tox Consult, Gouda, the Netherlands
Rene Stumpel
Medical Emergency Preparedness and Planning (GHOR) Gooi & Vechtstreek, Bussum, the Netherlands
Joris Yzermans
Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands
National Institute for Public Health and the Environment (RIVM), A. van Leeuwenhoeklaan 1, 3721 MA Bilthoven, the Netherlands E-mail:


A broad range of health problems are related to disasters. Insight into these health problems is needed for targeted disaster management. Disaster health outcome assessment can provide insight into the health effects of disasters.

During the 15th World Congress on Disaster and Emergency Medicine in Amsterdam (2007), experts in the field of disaster epidemiology discussed important aspects of disaster health outcome assessment, such as: (1) what is meant by disaster health outcome assessment?; (2) why should one conduct a disaster health outcome assessment, and what are the objectives?, and (3) who benefits from the information obtained by a disaster health outcome assessment?

A disaster health outcome assessment can be defined as a systematic assessment of the current and potential health problems in a population affected by a disaster. Different methods can be used to examine these health problems such as: (1) rapid assessment of health needs; (2) (longitudinal) epidemiological studies using questionnaires; (3) continuous surveillance of health problems using existing registration systems; (4) assessment of the use and distribution of health services; and (5) research into the etiology of the health effects of disasters.

The public health impact of a disaster may not be immediately evident. Disaster health outcome assessment provides insight into the health related consequences of disasters. The information that is obtained by performing a disaster health outcome assessment can be used to initiate and adapt the provision of health care. Besides information for policy-makers, disaster health outcome assessments can contribute to the knowledge and evidence base of disaster health outcomes (scientific objective). Finally, disaster health outcome assessment might serve as a signal of recognition of the problems of the survivors.

Several stakeholders may benefit from the information obtained from a disaster health outcome assessment. Disaster decision-makers and the public health community benefit from performing a disaster health outcome assessment, since it provides information that is useful for the different aspects of disaster management. Also, by providing information about the nature, prevalence, and course of health problems, (mental) health care workers can anticipate the health needs and requirements in the affected population.

It is important to realize that the disaster is not over when the acute care has been provided. Instead, disasters will cause many other health problems and concerns such as infectious diseases and mental health problems. Disaster health outcome assessments provide insight into the public health impact of disasters.

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Copyright © World Association for Disaster and Emergency Medicine 2008

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1.Noij, EKDisaster epidemiology. Disaster Medicine 1996;14(2):289300.Google Scholar
2.Noji, EKThe public health consequences of disasters. Prehospital Disaster Med 2000;15(4):147157.Google Scholar
3. International Consortium for Research on the Health Effects of Radiation Writing Committee and Study Team, Davis, S, Day, RW, et al. : Childhood leukaemia in Belarus, Russia, and Ukraine following the Chernobyl power station accident: Results from an international collaborative populationbased case-control study. Int J Epidemiol 2006;35(2):386396.Google Scholar
4.Rubonis, AV, Bickman, LPsychological impairment in the wake of disaster: The disaster-psychopathology relationship. Psychol Bull 1991;109(3):384399.Google Scholar
5.Norris, FH, Friedman, MJ, Watson, PJ, et al. : 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 2002;65(3):207239.Google Scholar
6.Galea, S, Nandi, A, Vlahov, DThe epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev 2005;27:7891.Google Scholar
7.Varma, DREpidemiological and experimental studies on the effects of methyl isocyanate on the course of pregnancy. Environ Health Perspect 1987;72:153157.Google Scholar
8.Yzermans, J, Gersons, BPR The chaotic aftermath of an airplane crash in Amsterdam. In: JM, Havenaar, Cwikel, JG, Bromet, EJ (eds): Toxic Turmoil: Psychological and Societal Consequences of Ecological Disasters.2002, pp 8599.Google Scholar
9.Ruijten, MThe Dutch experience with health impact assessment of disasters. Eur J Public Health 2007;17(1):56.Google Scholar
10.Roorda, J, van Stiphout, WA, Huijsman-Rubingh RR: Post-disaster health effects: strategies for investigation and data collection. Experiences from the Enschede firework disaster. J Epidemiol Community Health 2004;58(12):982987.Google Scholar
11.Grievink, L, Velden PG van, der, Christiaanse, B, et al. : Gezondheid getroffenen vier jaar na de vuurwerkramp Enschede. 2004;IvP: 99 2004 2; RIVM: 630930005:1-B52 [Dutch Report]Google Scholar
12.Lang, T, Schwoebel, V, Diène, E, et al. : Assessing post-disaster consequences for health at the population level: Experience from the AZF factory explosion in Toulouse. J Epidemiol Community Health 2007;61(2):103107.Google Scholar
13.Rivière, S, Schwoebel, V, Lapierre-Duval, K, et al. : Predictors of symptoms of post-traumatic stress disorder after the AZF chemical factory explosion on September 21, 2001, in Toulouse, France. J Epidemiol Community Health 2008: in press.Google Scholar
14.Kilbourne, EM, Choi, K, Jones, TS, et al. : Risk factors for heatstroke. A casecontrol study. JAMA 1982;247(24):33323336.Google Scholar
15.Rivière, S, Schwoebel, V, Lapierre-Duval, K, et al. : Hearing status after an industrial explosion: experience of the AZF explosion, 21 September 2001, France. Int Arch Occup Environ Health 2008;81(4):409414.Google Scholar
16.Berg B van, den, Grievink, L, Stellato, RK, et al. : Symptoms and related functioning in a traumatized community. Arch Intern Med 2005;165(20):24022407.Google Scholar
17.Dirkzwager, AJ, Velden PG van, der, Grievink, L, et al. : Disaster-related posttraumatic stress disorder and physical health. Psychosom Med 2007;69(5):435440.Google Scholar
18.Dorn, T, Yzermans, CJ, van der Zee, JProspective cohort study into post-disaster benzodiazepine use demonstrated only short-term increase. J Clin Epidemiol 2007;60(8):795802.Google Scholar
19.Donker, GA, Yzermans, CJ, Spreeuwenberg, P, et al. : Symptom attribution after a plane crash: Comparison between selfreported symptoms and GP records. Br J Gen Pract 2002;52(484):917922.Google Scholar
20.Huizink, AC, Slottje, P, Witteveen, AB, et al. : Long-term health complaints following the Amsterdam Air Disaster in police officers and fire-fighters. Occup Environ Med 2006;63(10):657662.Google Scholar
21.Enserink, MFrance. Twenty years after Chornobyl, legal fallout lingers. Science 2006;312(5779):1455.Google Scholar
22.Leenhardt, L, Grosclaude, P, Chérie-Challine, L et al. : Recommendations pour la mise en place d'un dispositif de surveillance épidémiologique nationale. 2002. Institut de Veille Sanitaire, Saint Maurice. [French Report].Google Scholar